Organization Active NPI

Gloversville Family Dentistry,LLP

  • General Practice Dentistry
  • Gloversville, NY
National Provider Identifier
1114025707
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GLOVERSVILLE FAMILY DENTISTRY,LLP
Practice address
22 1St Ave
Gloversville, NY 12078-3102
Phone
(518) 725-1031
Fax
(518) 773-4310
NPI assigned
Sep 20, 2006
Last updated
Jan 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Andrew S Levine, DDS
Title
Owner
Phone
(518) 725-1031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

22 1St Ave
Gloversville, NY 12078-3102

Mailing address

PO Box 393
Gloversville, NY 12078-0004
Phone (518) 725-1031

Other identifiers 3

IdentifierTypeStateIssuer
00915797MedicaidNY
7682OtherNYCDPHP
731610OtherNYUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

22 1st Ave
Gloversville, NY 12078
Phone (518) 725-1031

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1114025707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120780004",
            "telephone_number": "518-725-1031",
            "fax_number": "518-773-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 1ST AVE",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783102",
            "telephone_number": "518-725-1031",
            "fax_number": "518-773-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOVERSVILLE FAMILY DENTISTRY,LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-725-1031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00915797",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "7682",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "731610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.